Verification of Benefits Specialist

Position OverviewCareer Strategies is seeking a detail-oriented Verification of Benefits Specialist to join our healthcare team. This role is responsible for verifying patient insurance coverage, determining eligibility for services, and communicating benefit information to patients and healthcare providers to ensure proper reimbursement and financial clearance prior to service delivery.Key ResponsibilitiesContact insurance companies to verify patient benefits and eligibility for medical, behavioral health, and/or specialty servicesAccurately document all insurance information including coverage details, co-pays, deductibles, out-of-pocket maximums, and authorization requirementsDetermine patient financial responsibility and communicate this information clearly to patients and clinical teamsIdentify and resolve insurance discrepancies or issues prior to service deliveryVerify in-network vs. out-of-network status and explain implications to patientsObtain necessary pre-authorizations or referrals according to insurance requirementsMaintain detailed records of all verification activities in electronic health record systemsStay current with insurance plan changes, policy updates, and industry regulationsAssist with insurance-related questions from patients, providers, and staffSupport the revenue cycle team by helping to prevent claim denials through accurate pre-service verificationQualificationsHigh school diploma required; Associate's degree in healthcare administration, medical billing, or related field preferred2+ years of experience in insurance verification, medical billing, or healthcare administrationKnowledge of medical terminology, CPT/HCPCS codes, and ICD-10 diagnosis codesExperience working with various insurance payers including commercial, Medicare, Medicaid, and managed care organizationsProficiency in navigating insurance portals (e.g., Availity, Navinet, Emdeon) and verifying benefits through online platformsStrong computer skills including electronic health records systems and Microsoft Office SuiteExcellent verbal and written communication skills for interacting with insurance representatives and patientsDetail-oriented with strong organizational abilities and time management skillsAbility to interpret complex insurance policy information accurately